Assessment and treatment of major depression in older adults
Abstract
Late life depression is a significant public health problem as well as a burden on patients, their families, and caregivers. There are significant associations of late life depression with medical disorders and cognitive impairment, the latter due to effects of the depression itself or association with dementia. Diagnostic criteria and screening tests have continued to evolve and provide structure and guidelines for assessment. Accurate diagnosis and treatment are of utmost importance to improve quality of life, alleviate suffering, and prevent suicide. A number of effective antidepressant medications are available; combination therapy with these medications and cognitive behavioral therapy appear most efficacious, and maintenance therapy can decrease the chances of remission. A sequence for treatment of late life depression is provided, with strategies for treatment-resistant depression. The relationship of dementia to depression and the interaction of depression with mechanisms of aging are major foci of research.
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Rates of nonresponse to first-line antidepressants in late-life depression range from 55% to 81%.
“Current pharmacological treatments for late-life depression have well-established but modest efficacy, with rates of nonresponse to first-line antidepressants ranging from 55% to 81%.1”
Current pharmacological treatments for late-life depression have well-established but modest efficacy.
“Current pharmacological treatments for late-life depression have well-established but modest efficacy, with rates of nonresponse to first-line antidepressants ranging from 55% to 81%.1”
Nonresponse to first-line antidepressant treatment in older adult patients contributes to diminished quality of life.
“Nonresponse to first-line antidepressant treatment in older adult patients contributes to diminished quality of life.1”
Cites
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Self-citationShear, M. K. (2015) · New England Journal of Medicine · doi:10.1056/nejmcp1315618 · Cited by 533 · see citing works
Maintenance Treatment of Major Depression in Old Age
Reynolds, C. F., Dew, M. A., Pollock, B. G., Mulsant, B. H., Frank, E., Miller, M. D., Houck, P. R., Mazumdar, S., Butters, M. A., Stack, J. A., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052619 · Cited by 476 · see citing works
Self-citationLenze, E. J., Mulsant, B. H., Blumberger, D. M., Karp, J. F., Newcomer, J. W., Anderson, S. J., Dew, M. A., Butters, M. A., Stack, J. A., Begley, A. E., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00308-6 · Cited by 283 · see citing works
Self-citationGallo, J. J., Morales, K. H., Bogner, H. R., Raue, P. J., Zee, J., Bruce, M. L., & Reynolds, C. F. (2013) · BMJ · doi:10.1136/bmj.f2570 · Cited by 172 · see citing works
Self-citationReynolds, C. F., Butters, M. A., Lopez, O., Pollock, B. G., Dew, M. A., Mulsant, B. H., Lenze, E. J., Holm, M., Rogers, J. C., Mazumdar, S., et al. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.184 · Cited by 171 · see citing works
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Blumberger, D. M., Mulsant, B. H., Thorpe, K. E., McClintock, S. M., Konstantinou, G. N., Lee, H. H., Nestor, S. M., Noda, Y., Rajji, T. K., Trevizol, A. P., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.2862 · Cited by 142 · see citing works
Self-citationSocial determinants of late-life depression epigenetics
Lozupone, M., & Panza, F. (2020) · Epigenomics · doi:10.2217/epi-2019-0392 · Cited by 15 · see citing works
Sun, Y., Tian, Z., Ma, Y., Zhu, Q., Zheng, R., Guan, Y., & Zhang, X. (2025) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.13138 · Cited by 12 · see citing works
- Authors
- Reynolds, C. F., Lenze, E. J., & Mulsant, B. H.
- Affiliations
- University of Pittsburgh (US)
- Washington University in St. Louis (US)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Charles F. Reynolds
- Venue
- Handbook of Clinical Neurology
- Publisher
- Elsevier
- Published
- 2019
- Volume
- 167
- Pages
- 429-435
- ISSN
- 0072-9752 (ISSN-L)
- OpenAlex
- W2984854557
- Cited by
- 73
- References
- 7
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 6 · 2023: 2 · 2022: 7 · 2021: 30 · 2020: 17
- FWCI
- 23.02
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Handbook of clinical neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- geriatric depression, depression screening, diagnostic criteria, antidepressants, cognitive behavioral therapy, maintenance therapy, treatment-resistant depression, cognitive impairment, dementia, suicide prevention, aging mechanisms, comorbidities
- MeSH terms
- Aged, Aged, 80 and over, Aging, Major Depressive Disorder, Female, Humans, Male
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